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Combating cancer, injury and disfigurement in the most socially important part of our bodies – the face and mouth

The face is the only part of our body we cannot hide. It conveys our emotions and innermost feelings. We often judge each other on the basis of facial appearance, making assumptions on a whole range of issues.

People suffer the consequences of facial diseases, injuries and disfigurement every day. In the United Kingdom 6,500 people develop oral cancer every year. Around 125,000 young people sustain serious facial injuries and 15,000 people receive treatment for facial disfigurement.

Despite the severity of these issues, this remains a much neglected research area leaving thousands of those unfortunate enough to be affected with little hope for the future. Not enough is known about facial disease, injury and deformity, their psychological and emotional impact and, critically, which treatments are most effective. Saving Faces - The Facial Surgery Research Foundation is the only charity in the UK solely dedicated to the worldwide reduction of facial injuries and diseases. We are taking the lead in education and research to improve the physical and psychological treatment of all victims of oral cancer and other facial diseases.

The sublingual gland is a salivary gland about the size of an almond that lies underneath the tongue in the floor of your mouth. Saliva drains from it through a number of small tubes that open on the inside of the mouth underneath the tongue. The most common reason for removing a sublingual gland is as a result of a blockage to these drainage tubes. This can lead to a swelling (ranula).

This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions. If you have any other questions that the leaflet does not answer or would like further explanation please ask.

What is the sublingual gland?

The sublingual gland is a salivary gland about the size of an almond that lies underneath the tongue in the floor of your mouth. Saliva drains from it through a number of small tubes that open on the inside of the mouth underneath the tongue. The most common reason for removing a sublingual gland is as a result of a blockage to these drainage tubes. This can lead to a swelling (ranula).

What does the operation involve?

The sublingual gland is removed under a general anaesthetic, ie: you are put to sleep completely. The operation involves making a cut around 2cm long (1½") underneath the tongue on the inside of the lower teeth. Once the gland has been removed the incision is held together again with stitches. These are usually dissolvable but may take several weeks to disappear.

How long will the operation take?

The length of time partly depends upon the degree of difficulty. In an uncomplicated procedure it will take approximately 30 minutes to remove the sublingual gland.

What can I expect after the operation?

You usually require a night in hospital following the surgery. It is unlikely to be very sore but regular painkillers will be arranged for you. There is relatively little swelling following submandibular gland removal.

Do I need any time off work?

It is usually advisable to take a week off work to recover from the surgery. During this time you should avoid strenuous activity. It is important to remember that you will not be able to drive or operate machinery for 48 hours after your general anaesthetic.

Will I have a scar?

At the time of surgery the wound is only gently held together with a few stitches so initially you will see some gaps. Please do not be concerned by this. All cuts leave a scar but inside the mouth the majority of these fade with time and are difficult to see when they are fully healed. It will take a couple of months for your scar to fade completely.

What are the possible problems?

Bleeding from the wound is unlikely to be a problem. If it occurs it usually does so within the first 12 hours of surgery which is why you need to stay in hospital overnight.

Infection is uncommon but if your surgeon thinks it may happen to you a short course of antibiotics will be arranged. What are the possible complications? There are potential complications with any operation. Fortunately with this type of surgery complications are rare and may not happen to you. However it is important that you are aware of them and have the opportunity to discuss them with your surgeon.

Numbness of the tongue - the lingual nerve which supplies feeling to the side of the tongue can become bruised as a result of surgery. If this occurs you will experience a tingly or numb feeling in the tongue, similar to the sensation after having an injection at the dentist. This numbness may take several months to disappear and in a minority of patients may last for ever.

Damage to the submandibular duct - the submandibular duct is the name of the tube which carries saliva from the submandibular gland into the mouth. The submandibular gland is a salivary gland about the size of a plum that lies immediately below the lower jaw at the top of the neck. The duct runs close to the sublingual gland before opening on the inside of the mouth under the tongue immediately behind the lower front teeth. If this duct is damaged saliva may not drain properly from the submandibular gland and the gland may therefore swell in the upper part of the neck. The majority of these swellings settle down on their own.

Are there are any long-term effects of having my sublingual gland removed?

The removal of one sublingual gland will not have an impact on the amount of saliva that you produce. There are many other saliva glands left in and around your mouth that will still keep it moist.

Will I need further appointments?

A review appointment will be arranged before you leave hospital to see your surgeon again.